title: Dual-source computed tomography coronary angiography in patients with high heart rate.
abstract: Although single-source 64-multislice computed tomography coronary angiography (SSCTA) needs to reduce heart rate (HR), dual-source computed tomography coronary angiography (DSCTA) can acquire images even in tachycardia. The accuracy of DSCTA during tachycardia is compared to the accuracy of SSCTA at reduced HR. Patients who received invasive coronary angiography and either SSCTA or DSCTA were included. In the SSCTA group, HR was reduced to <65 beats per minute (bpm) with β-blocker (n = 27), while in the DSCTA group patients whose HR was >65 bpm were selected (n = 27). The diagnostic accuracy for significant coronary stenosis was calculated by comparing the invasive coronary angiography. Using dual-Doppler echocardiography, isovolumic relaxation time (IRT) and diastasis time (DT) were evaluated in these patients. In SSCTA, sensitivity was 89 %, specificity 99 %, the positive predictive value (PPV) 94 %, and the negative predictive value (NPV) was 98 %. In DSCTA, sensitivity was 96 %, the specificity was 99 %, PPV was 91 %, and NPV was 99 % (all NS compared to SSCTA). When HR was >75 bpm, DT was markedly shortened (<83 ms), however IRT was maintained >85 ms. Thus, the image reconstruction at the phase of IRT is feasible in DSCTA because of its temporal resolution of 83 ms. High temporal resolution of DSCTA shows equivalent accuracy of coronary stenosis detection to SSCTA, without reducing heart rate, because of its image reconstruction at IRT.
authors.affiliation: Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, 755-8505, Japan.
authors.forename: Tatsuhiro
authors.initials: T
authors.lastname: Fujimura
authors.forename: Toshiro
authors.initials: T
authors.lastname: Miura
authors.forename: Tomoko
authors.initials: T
authors.lastname: Nao
authors.forename: Masayuki
authors.initials: M
authors.lastname: Yoshimura
authors.forename: Yoshiteru
authors.initials: Y
authors.lastname: Nakashima
authors.forename: Munemasa
authors.initials: M
authors.lastname: Okada
authors.forename: Takayuki
authors.initials: T
authors.lastname: Okamura
authors.forename: Jutaro
authors.initials: J
authors.lastname: Yamada
authors.forename: Chikage
authors.initials: C
authors.lastname: Ohshita
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Wada
authors.forename: Naofumi
authors.initials: N
authors.lastname: Matsunaga
authors.forename: Masunori
authors.initials: M
authors.lastname: Matsuzaki
authors.forename: Masafumi
authors.initials: M
authors.lastname: Yano
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D015150:Echocardiography, Doppler; D005240:Feasibility Studies; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D011237:Predictive Value of Tests; D011857:Radiographic Image Interpretation, Computer-Assisted; D012720:Severity of Illness Index; D013610:Tachycardia / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology*; D013997:Time Factors
chemical_list: D000319:Adrenergic beta-Antagonists; D000889:Anti-Arrhythmia Agents